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| Value of indices in early diagnosis of cardiac surgery associated acute kidney injury |
| Jin Ke, Wang Qiu-hui, Dong Liang, Yan Jie |
| Intensive Care Unit, Wuxi People′s Hospital, Wuxi 214023, China |
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Abstract Objective To evaluate the diagnostic value of urinary indices of cardiac surgery associated acute kidney injury (AKI) at early stage. Methods We performed a prospective study on patients undergoing cardiac surgery. The urine neutrophil gelatinase-associated lipocalin (NGAL), fractional excretion of sodium (FENa), fractional excretion of urea (FEU) measured at before surgery and 1, 6, 24 h following surgery. According to the incidence of AKI, the patients were divided into AKI group and no AKI group. The changes of those urinary indices were analyzed. Results 76 patients were enrolled; 21 (27.6%) patients after cardiac surgery developed AKI. Age, male rate, APACHE Ⅱ score, aortic cross-clamp time and length of ICU stay in AKI group were significantly higher than in no AKI group (P＜0.05). Urine NGAL in patients with AKI was significantly higher compared with that in patients without AKI 24 h after cardiac surgery (P＜0.05). FENa was statistically significant 1,6, 24 h after cardiac surgery between two groups (P＜0.05); and it was also statistically significant 6 h after cardiac surgery between two groups (P＜0.05). 24 h after cardiac surgery, the AUC of urinary NGAL was 1.000; the sensitivity was 1.0 and specificity was 1.0 with a cutoff value of 36.9 ng/mL. The AUC of FENa was 0.897; the sensitivity was 0.851 and specificity was 0.782 with a cutoff value of 1.8, at the time point of 1 h after cardiac surgery. FEU showed a 0.952 sensitivity and 1.000 specificity with a cutoff value of 26.5; the AUC was 0.997 6 h after cardiac surgery. Conclusion 6 h FEU, 24 h urine NGAL after cardiac surgery are predictive of AKI. 6 h FEU is useful as an early diagnosis indicator.
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Received: 07 February 2017
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Corresponding Authors:
Wang Qiu-hui, E-mail:qiuhui4403@sina.com
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